Cone-beam computed tomography (CBCT) is a useful diagnostic tool for identification of both internal and external root configurations. This case report describes the endodontic management of a lateral incisor with both dens invaginatus and external root irregularity by using CBCT. Nonsurgical endodontic retreatment was performed on the lateral incisor with dens invaginatus. A perforation through the dens invaginatus and external concavity was repaired using mineral trioxide aggregate. After 18 mon of follow-up, there were no clinical symptoms. Recall radiographs appeared normal and showed healing of the periapical pathosis. The understanding of both internal root canal configuration and external root irregularity using CBCT can ensure predictable and successful results.

Maxillary canines have less anatomical diversities than other teeth. They usually have a single root and root canal. This report describes an endodontic treatment of a maxillary canine with two separated root canals which have not been reported through the demonstration of radiography and computerized tomography (CT).

Even though appropriated endodontic treatment has been performed, the severe pain could happen due to lack of consideration of anatomical variations of the teeth. Therefore, the clinicians should be well aware of the possibility of anatomical variations in the root canal system during endodontic treatment even if the number of root canals is obvious such as in this case.